Department of Infectious Diseases, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China (mainland).
Department of Infectious Diseases, Yidu Central Hospital of Weifang Affiliated to Weifang Medical University, Weifang, Shandong, China (mainland).
Med Sci Monit. 2021 Nov 8;27:e932836. doi: 10.12659/MSM.932836.
BACKGROUND Severe fever with thrombocytopenia syndrome is a serious insect-borne infectious disease caused by the Huaiyangshanbanyang virus. We conducted a retrospective study to identify risk factors for neurological complications caused by the virus. MATERIAL AND METHODS We included 121 patients who had severe fever with thrombocytopenia syndrome and were admitted to our hospital from 2013 to 2020. Patients' laboratory test results and clinical data were collected. Univariate and multivariate regression were used for statistical analysis. RESULTS Patients with neurological complications had higher mortality rates and longer hospital stays and disease duration than did patients without neurological complications. The neurological symptoms with the highest incidence rates were involuntary tremors (tongue and mandible), cognitive disorder, and limb tremors. Patients with neurological complications had a higher incidence of abnormal heart rhythms. Subcutaneous bleeding, pulmonary rales, percentage of neutrophils, increased lactate dehydrogenase and C-reactive protein levels, and decreased chloride ion concentration were closely related to the occurrence of neurological complications. The significant decrease in chloride ion concentration within 1 to 5 days of disease onset may be a risk factor for predicting the occurrence of neurological complications in patients with severe fever with thrombocytopenia syndrome. CONCLUSIONS Early monitoring of subcutaneous bleeding, pulmonary rales, electrocardiogram changes, and biochemical indicators in patients with severe fever with thrombocytopenia syndrome can predict the occurrence of neurological complications.
发热伴血小板减少综合征是由淮阳山恙病毒引起的一种严重的虫媒传染病。我们进行了一项回顾性研究，以确定该病毒引起的神经并发症的危险因素。
我们纳入了 2013 年至 2020 年期间我院收治的 121 例发热伴血小板减少综合征患者。收集患者的实验室检查结果和临床资料。采用单因素和多因素回归进行统计学分析。
有神经并发症的患者死亡率和住院时间、疾病持续时间均高于无神经并发症的患者。发病率最高的神经症状是不自主震颤（舌和下颌）、认知障碍和肢体震颤。有神经并发症的患者心律失常发生率较高。皮下出血、肺部啰音、中性粒细胞百分比、乳酸脱氢酶和 C 反应蛋白水平升高以及氯离子浓度降低与神经并发症的发生密切相关。发病后 1 至 5 天氯离子浓度显著降低可能是预测发热伴血小板减少综合征患者发生神经并发症的危险因素。
早期监测发热伴血小板减少综合征患者的皮下出血、肺部啰音、心电图变化和生化指标，有助于预测神经并发症的发生。
